Provider Demographics
NPI:1861043820
Name:LATINO EXECUTIVE, INC
Entity type:Organization
Organization Name:LATINO EXECUTIVE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-301-5101
Mailing Address - Street 1:10920 CORONA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3943
Mailing Address - Country:US
Mailing Address - Phone:718-699-0960
Mailing Address - Fax:
Practice Address - Street 1:10920 CORONA AVE STE 1
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3943
Practice Address - Country:US
Practice Address - Phone:718-699-0960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB03259OtherNEW YORK CITY TAXI LIMOUSINE COMMISSION